Abstract: Regenerative medicine focuses on replacing and repairing damaged tissues and organs to restore their normal structure and function. Common techniques in regenerative medicine include tissue engineering, organ transplantation, and cell-free therapy. Cell-free therapy has gained attention due to its potential to reduce immune rejection and tumorigenicity, emerging as a prominent area in regenerative medicine research. The advancement of cell-free therapy has been facilitated by the discovery of extracellular vesicles (EVs), which are small membranous structures released by cells and play crucial roles in intercellular communication. EVs show promise as therapeutic agents and drug delivery vehicles. However, challenges such as short half-life, lack of targeting, and poor retention hinder their effectiveness. Hydrogels offer a solution by enhancing the stability and retention of EVs in vivo, thereby improving their therapeutic potential. In this context, researchers have explored hydrogel-based delivery systems for EVs. This review systematically summarizes recent developments in hydrogel-based EVs delivery systems within the field of regenerative medicine, highlighting both opportunities and challenges for clinical applications.